Xu Songtao, Xi Junjie, Jiang Wei, Lu Shaohua, Wang Qun
Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Xuhui District, Shanghai, China.
Department of Pathology, Zhongshan Hospital, Fudan University, Xuhui District, Shanghai, China.
Ann Thorac Surg. 2015 Mar;99(3):961-7. doi: 10.1016/j.athoracsur.2014.10.079. Epub 2015 Jan 27.
Prognostic factors for stage IB lung cancer remain controversial. The International Association for the Study of Lung Cancer, American Thoracic Society, and European Respiratory Society proposed a new classification for pulmonary adenocarcinoma. We investigated the prognostic value of this new classification in resected stage IB pulmonary adenocarcinoma.
The study included 187 patients with stage IB pulmonary adenocarcinoma. All pathologic slides were reevaluated according to the new classification for pulmonary adenocarcinoma, with each histologic component recorded in 5% increments. Survival analyses were performed to determine the prognostic factors for stage IB pulmonary adenocarcinoma.
Univariable analysis showed tumor size was prognostic for overall survival (hazard ratio [HR], 2.083; p < 0.001) and progression-free survival (HR, 1.991; p < 0.001); gender (HR, 0.558; p = 0.033), presence of the solid component (HR, 1.976; p = 0.016), and presence of a micropapillary component (HR, 2.371; p = 0.018) were prognostic for progression-free survival. Multivariable analysis revealed that tumor size was an independent prognostic factor for overall survival (HR, 2.083; 95% confidence interval, 1.433 to 3.029; p < 0.001) and progression-free survival (HR, 2.036; 95% confidence interval, 1.546 to 2.681; p < 0.001) and that the presence of the solid component (HR, 2.045; 95% confidence interval, 1.172 to 3.568; p = 0.012) was an independent prognostic factor for progression-free survival.
Solid component and tumor size significantly correlate with prognosis in stage IB pulmonary adenocarcinoma.
IB期肺癌的预后因素仍存在争议。国际肺癌研究协会、美国胸科学会和欧洲呼吸学会提出了一种新的肺腺癌分类方法。我们研究了这种新分类方法在接受手术的IB期肺腺癌中的预后价值。
该研究纳入了187例IB期肺腺癌患者。所有病理切片均根据新的肺腺癌分类方法重新评估，每个组织学成分按5%的增量记录。进行生存分析以确定IB期肺腺癌的预后因素。
单变量分析显示，肿瘤大小对总生存期（风险比[HR]，2.083；p < 0.001）和无进展生存期（HR，1.991；p < 0.001）具有预后意义；性别（HR，0.558；p = 0.03）、实性成分的存在（HR，1.976；p = 0.016）和微乳头成分的存在（HR，2.371；p = 0.018）对无进展生存期具有预后意义。多变量分析显示，肿瘤大小是总生存期（HR，2.083；95%置信区间，1.433至3.029；p < 0.001）和无进展生存期（HR，2.036；95%置信区间，1.546至2.681；p < 0.001）的独立预后因素，实性成分的存在（HR，2.045；95%置信区间，1.172至3.568；p = 0.012）是无进展生存期的独立预后因素。
实性成分和肿瘤大小与IB期肺腺癌的预后显著相关。
